Author:
Wang Shaowei,Zeng Xi,Zhang Qiongshuai,Li Heping
Abstract
Abstract
Purpose
With the improvement of people’s life expectancy, the incidence of stroke is high in the world. Post-stroke Dysphagia seriously affects people’s quality of life, among which malnutrition and pulmonary infection are the most common complications of post-stroke Dysphagia. At this point, it is very important to choose the right enteral and parenteral feeding mode. Current nutrition methods commonly used in patients with dysphagia after stroke include Intermittent oral to esophageal tube feeding (IOE), Nasogastric tube (NG), Nasal Jejunal feeding tubes (NJ), Percutaneous endoscopic gastrostomy (PEG).The purpose of this meta-analysis was to study the prognosis of patients with dysphagia after stroke who chose different nutritional methods.
Methods
We conducted a systematic review and meta-analysis of randomized controlled trials (RCTS) to examine the effects of different nutritional modalities on outcomes in patients with post-stroke dysphagia. We searched the Cochrane Library, PubMed, Medline, China National Knowledge Infrastructure (CNKI), Wanfang, and the VIP database. The search period is from the library's establishment to December 31, 2021.At least 2 reviewers independently assessed eligibility criteria, extracted data, and assessed the risk of bias. Standardized mean difference (SMD), relative risk (RR), and odds ratio (OR) were calculated using a random-effects model.
Results
Fourteen studies were identified across six databases that met the inclusion criteria, The results of meta-analysis showed that Intermittent oral to esophageal tube feeding (IOE) could improve the nutritional levels of patients better than nasogastric tube (NG) (MD 1.95, 95%CI 1.22–2.67, P < 0.00001, I2 = 0%), and reduced the incidence of aspiration pneumonia (RR 0.39, 95%CI 0.23–0.66, P = 0.0004, I2 = 0%), improved swallowing function (OR 3.92, 95%CI 2.15–7.14, P < 0.00001, I2 = 0%). Although Percutaneous endoscopic gastrostomy (PEG) can improve the nutrition of patients in the short term, the long-term prognosis remains to be discussed. In addition, the Nasal Jejunal feeding tubes (NJ) significantly reduced the incidence of post-stroke pneumonia compared with NG (RR 0.51, 95%CI 0.29–0.92, P = 0.03, I2 = 0%).
Conclusions
According to the results of meta-analysis, IOE can better improve the nutritional level of patients and reduce the incidence of complications. However, due to the lack of popularity and small target clients, patients who do not accept IOE enteral feeding for various reasons and choose nasal feeding can consider using NJ as a long-term enteral feeding method, and guard against adverse events when performing supplementary nutrition.
Publisher
Springer Science and Business Media LLC
Reference45 articles.
1. Collaborators GN. Global, regional, and national burden of neurological disorders, 1990–2016: a systematic analysis for the Global Burden of Disease Study 2016. Lancet Neurol. 2019;18(5):459–80. https://doi.org/10.1016/s1474-4422(18)30499-x.
2. Zhang T, Zhao J, Li X, et al. Chinese Stroke Association guidelines for clinical management of cerebrovascular disorders: executive summary and 2019 update of clinical management of stroke rehabilitation. Stroke Vasc Neurol. 2020;5(3):250–9. https://doi.org/10.1136/svn-2019-000321.
3. Yanyan W. Research progress of deglutition training and acupoint massage in the treatment of dysphagia after stroke. J Nurs Sci. 2016;31(05):106–10.
4. Chunlian L, Yan Q, Xiaohong L, Fengxia W, Yuan Z, Lehua Y. Clinical observation on the treatment of stroke complicated with dysphagia by low frequency pulse electrical stimulation combined with swallowing function training. Chongqing Med J. 2012;41(22):2247–8.
5. Guomin J. Comprehensive rehabilitation nursing of dysphagia in acute cerebral apoplexy patients. Chin J Pract Neurol Dis. 2007;06:146.
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